Nedaplatin for recurrent cancer of the head and neck

This study was undertaken to evaluate the clinical efficacy and toxicity of Nedaplatin (254-S) alone or combined for UFT for recurrent head and neck cancers in an outpatient setting. Thirty-two patients, previously treated, (30 men and 2 women, mean age 59 years, twenty one with loco-regional recurrence and 11 with distant metastasis, 29 with squamous cell carcinoma, 2 with adenocarcinoma and one with adenoid cystic carcinoma) were treated with Nedaplatin (254-S) alone or combined with UFT. The primary site was identified in the oropharynx in 8 patients, oral cavity in 7, larynx in 5, nasopharynx in 4, hypopharynx in 3, sinuses in one, parotid in one, and unknown primary in one patient. 254-S was administered at 80 mg/m2 by intravenous drip infusion. The 254-S administration was repeated at 4 week intervals, and in some patients was combined with daily oral administration of 400 mg of UFT-E (tegafur-uracil enterogranules). Twelve patients received 254-S alone and in 20 patients it was combined with UFT-E. The 254S administration ranged from one to 18 courses (mean of 5.7 courses). Grade 3-4 toxicities included leukopenia in 15.6%, anemia in 6.3% and thrombocytopenia in 9.4% of the patients. There was one death due to grade 4 leukopenic pneumonia. Four (12.5%) had a clinical complete and partial response. One-year and two-year overall survival rates were 35.6% and 30.5% for loco-regional recurrence, respectively. Ten of the eleven patients with distant metastasis died within six months and all patients were dead within 18 months, so a significant difference was observed in the overall survival rate between loco-regional recurrence and distant metastasis. Treatment with 254-S alone or combined UFT-E could be conducted in an outpatient setting and was able to improve the overall survival rate for recurrent head and neck cancer.